Virilism

VIRILISM (from Latin vir - man), the replacement of female secondary sexual characteristics in women by male ones. To a very slight degree, virilism is observed in some cases as a result of the climax, where the matter is limited only to the fact that facial features become sharper, body shapes lose the roundness characteristic of the female body, and the upper lip and chin become covered with more or less coarse hair. Another category of cases of virilism consists of so-called bearded women, wherein, with the exception of facial hair, some of such women present no other heterosexual deviations, remaining normal in sexual terms, menstruating, and even sometimes retaining the ability to bear children (cases of Laurence, Duhring, and others). Much more frequently, however, other features of virilism are simultaneously present: a strong, rough voice, metabolic disturbances, and the like. Rare cases of transient facial hair have also been described: such is, for example, the case of Slocum, where the matter concerns a woman in whom facial hair appeared periodically during each pregnancy and disappeared some time after childbirth. Complete virilism is observed occasionally in adrenal hypernephromas, wherein virilism appears in such cases as one of the symptoms of so-called hirsutism (see); simultaneously, women acquire a male voice, male body shapes; a shift in the male direction may also take place in the psychological sphere. The mechanism of virilism remains far from elucidated. According to some authors, the adrenal cortex supposedly secretes an incret that promotes the manifestation of secondary male sexual characteristics, which makes itself felt especially demonstratively in adrenal hypernephromas, equivalent in their pathological significance to the hypertrophy of this organ. A. Kohn, conversely, thinks that the matter here does not lie in the adrenal cortex as such, but in the discarded and scattered remnants of the embryonic mass of the male part of a bisexually predisposed ovary, which secrete intensively during hypernephromas. Peritz approaches the explanation of the phenomenon from the standpoint of the doctrine of so-called dependent and independent sexual characteristics; namely: some of the secondary sexual characteristics depend on the hormones of the gonads, while others do not depend on them and are present in potential in both sexes and, if they appear in only one of them, it is only by virtue of their suppression by the sex hormone of the other sex; upon the loss of such a brake, conditions are provided for their manifestation here as well: thus, a castrated hen acquires rooster plumage and spurs. In humans, according to the designated point of view, such features usually characteristic of the male sex as a coarse voice, male hair growth, and corresponding body shapes could be considered independent sexual characteristics. Upon the loss or weakening of ovarian function during the climax and from other causes, these characteristics can therefore appear in women as well. Virilism in adrenal hypernephromas is interpreted by Peritz from the standpoint of an inhibitory effect from the adrenal cortex on the ovaries. However, a whole series of facts leads to the conclusion that there are cooperative rather than antagonistic relationships between the adrenal cortex and the gonads, as a result of which the question of dysfunction of the adrenal cortex in the designated cases could be raised. Conversely, the virilism of purely ovariogenic origin (without adrenal lesion) admitted by some authors could very conveniently be explained in the light of the doctrine of independent sexual characteristics. Sicard also speaks of pineal virilism (in tumors of the pineal gland), the existence of which, however, in the opinion of Sakharov, is doubtful.